Laboratory of Bacterial Pathogenesis and Immunology, Rockefeller University, 1230 York Avenue, New York, NY, USA.
Central European Institute of Technology (CEITEC), Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic.
Eur Spine J. 2019 Dec;28(12):2951-2971. doi: 10.1007/s00586-019-06086-y. Epub 2019 Jul 29.
Recent research shows an increasing recognition that organisms not traditionally considered infectious in nature contribute to disease processes. Propionibacterium acnes (P. acnes) is a gram-positive, aerotolerant anaerobe prevalent in the sebaceous gland-rich areas of the human skin. A ubiquitous slow-growing organism with the capacity to form biofilm, P. acnes, recognized for its role in acne vulgaris and medical device-related infections, is now also linked to a number of other human diseases. While bacterial culture and molecular techniques are used to investigate the involvement of P. acnes in such diseases, definitive demonstration of P. acnes infection requires a technique (or techniques) sensitive to the presence of biofilms and insensitive to the presence of potential contamination. Fortunately, there are imaging techniques meeting these criteria, in particular, fluorescence in situ hybridization and immunofluorescence coupled with confocal laser scanning microscopy, as well as immunohistochemistry.
Our literature review considers a range of microscopy-based studies that provides definitive evidence of P. acnes colonization within tissue from a number of human diseases (acne vulgaris, degenerative disc and prostate disease and atherosclerosis), some of which are currently not considered to have an infectious etiology.
RESULTS/CONCLUSION: We conclude that P. acnes is an opportunistic pathogen with a likely underestimated role in the development of various human diseases associated with significant morbidity and, in some cases, mortality. As such, these findings offer the potential for new studies aimed at understanding the pathological mechanisms driving the observed disease associations, as well as novel diagnostic strategies and treatment strategies, particularly for degenerative disc disease. These slides can be retrieved under Electronic Supplementary Material.
最近的研究表明，人们越来越认识到，传统上不被认为具有传染性的生物会导致疾病过程。痤疮丙酸杆菌（P. acnes）是一种革兰氏阳性、需氧厌氧微生物，普遍存在于人类皮肤的皮脂腺丰富区域。作为一种无处不在的缓慢生长的生物，具有形成生物膜的能力，P. acnes 因其在寻常痤疮和与医疗器械相关的感染中的作用而被认识，但现在也与许多其他人类疾病有关。虽然细菌培养和分子技术被用于研究 P. acnes 在这些疾病中的作用，但要明确证明 P. acnes 感染，需要一种对生物膜存在敏感而对潜在污染不敏感的技术（或技术）。幸运的是，有一些符合这些标准的成像技术，特别是荧光原位杂交和免疫荧光结合共聚焦激光扫描显微镜，以及免疫组织化学。
我们的文献综述考虑了一系列基于显微镜的研究，这些研究提供了明确的证据，证明 P. acnes 在来自多种人类疾病（寻常痤疮、退行性椎间盘和前列腺疾病以及动脉粥样硬化）的组织中定植，其中一些疾病目前不被认为具有传染性病因。
结果/结论：我们得出结论，P. acnes 是一种机会性病原体，在与发病率显著相关的各种人类疾病的发展中可能被低估了作用，在某些情况下甚至与死亡率相关。因此，这些发现为旨在理解驱动观察到的疾病关联的病理机制的新研究提供了潜力，以及新的诊断策略和治疗策略，特别是针对退行性椎间盘疾病。这些幻灯片可以在电子补充材料中检索到。
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